Wednesday, 26 August 2015

Thought for the Day: should mindfulness be taught in schools?


The long summer holidays are almost over and school is back just next week. How many children listen to Thought for the Day on the Radio 4 Today programme at 7.50am as they pull on school uniforms and pack sports kits and musical instruments at the start of a new school day? I’m guessing probably not that many… But they miss out on some good stuff about them!

Last Thursday I was in my kitchen piling fresh sandwiches into my lunch box as Vishvapani Blomfield read his latest Thought for the Day. I was stopped midway between slicing camembert and beefsteak tomatoes by some very thought-provoking words. Vishvapani is a Buddhist writer and mindfulness teacher based in Cardiff. According to his Wise Attention website his work explores how “time-honoured Buddhist practices such as mindfulness and meditation can be accessible forces for social change in the modern world”.

My rhubarb yoghurt hit the lunch box. And Vishvapani was on to the recently published The Good Childhood Report – research carried out over the past decade by The Children’s Society. This indicates that when it comes to reported wellbeing British children languish in a table of 15 countries at number 14, below Algeria and Ethiopia.

Vishvapani continued: “It's sad news; and we know from elsewhere that mental health difficulties are rising sharply among young people. Bullying is a particular problem and English girls are especially prone to feeling bad about their appearance and confidence. But why is this happening?”

“Various causes are proposed — our exam-focused education system, the influence of advertising and social media and so on. A common thread is that they encourage us to compare ourselves to other people or an idealised view of how things should be — how we should look, what we should achieve or the perfect existence we ought to be having. Psychologists call this 'the discrepancy monitor'.”


When looking at children aged 14 – 15, the researchers carried out an interesting exercise by analysing “the most commonly occurring words in children’s responses, which included ‘friends’, ‘family’, ‘bullying’, ‘parents’, ‘school’, ‘drugs’, ‘home’, ‘fun’, ‘education’ and ‘money’". Bullying is number three in the list.

Clare Foster wrote about the “discrepancy monitor” on the Everyday Mindfulness website, in her piece Social Media, Mental Health & Mindfulness. Elsewhere extensive research has been done over the past decade looking into why “people suffering from depression often believe themselves to be falling short of their own or other’s goals or expectations.”

Vishvapani’s Thought continued. He went on to suggest that rather than constantly comparing themselves with others, young people could focus on the present moment, using a technique used in many mindfulness approaches. “Pausing and accessing a sense of calm can create the space for a young person to start letting go of the anxious belief that they're fat or ugly, or don't fit in.”

Many of the researchers reach the same conclusions, that “people who engage in prolonged periods of meditation practice report that it profoundly alters their concepts and experiences of self”. So what is happening in schools? Are children able to engage in mindfulness? 


The Mindfulness in Schools Project is a non-profit organisation whose aim is to encourage, support and research the teaching of secular mindfulness in schools. Teachers who practise mindfulness themselves can sign up to a 3 day course to teach “Paws b” – a mindfulness course for 7 – 11 year olds.

The Mindfulness Foundation promotes the Mindfulness in Schools Campaign and wants to make mindfulness available to all UK school children. It’s strapline is: "Mindfulness in Schools - as important as sport and as politically relevant as health."

And last month a large-scale trial was launched by the Wellcome Trust to assess the effectiveness of teaching mindfulness in UK schools. It will involve 76 schools and up to 6,000 students aged 11 – 14 “to establish whether and how mindfulness improves the mental resilience of teenagers, and an evaluation of the most effective way to train teachers to deliver mindfulness classes to students”.

It sounds like a good start. What do you think? Should all children receive teaching in mindfulness, and would that help address the so-called “discrepancy monitor”? Let us know your thoughts in the comments box below.

And, by the way, there is mindfulness training for adults coming up here in Powys very soon. Mid Powys Mind is offering a new Autumn 2015 mindfulness course, with teacher Jo Mussen, at Crossgates near Llandrindod Wells. Tuesdays 10.30am – 1pm, orientation session 15 September, course 29 September – 24 November.

Finally, the Centre for Mindfulness Research & Practice – holds its All Wales Mindfulness Practitioners’ Network Day on 3rd September 2015 at Bangor University. It is the second event to bring mindfulness practitioners, teachers and trainers working across Wales together. So, as the new school term in Powys starts, Sarah Silverton, of the Mindfulness in Schools Project, will talking about Mindfulness Education.

Tuesday, 18 August 2015

Diwrnod yn Eisteddfod 2015 Our day at the Eisteddfod 2015


Ar 5ed Awst bu ein tîm yn helpu ar stondin PAVO a Chyngor Gweithredu Gwirfoddol Cymru (WCVA) ar y cyd yn Eisteddfod Genedlaethol Cymru. Cynhaliwyd yr eisteddfod eleni ar gaeau Mathrafal ger pentref Meifod yng Ngogledd Powys. I’r rhai hynny ohonoch sydd heb ymweld â’r Ŵyl, gweler isod disgrifiad ohoni:

On 5 August our team helped staff the joint PAVO and Wales Council for Voluntary Action (WCVA) stand at the National Eisteddfod of Wales which this year was hosted by the village of Meifod in North Powys. For readers who have yet to visit the annual Eisteddfod Festival, it is described as:

“Uchafbwynt calendr diwylliannol Cymru, sy’n teithio o le i le, sy’n ymweld â’r Gogledd a’r De bob yn ail, a thrwy hynny’n rhoi cyfle i gymunedau ar draws y wlad groesawu hyd at 160,000 o ymwelwyr dros gyfnod o wyth niwrnod.”

“The pinnacle of the Welsh cultural calendar, it travels from place to place, alternating between north and south Wales, giving communities across the country a chance to welcome up to 160,000 visitors over an eight day period.”

Chwith i dde: Freda Lacey (PAVO), Gill Colerick (Hafal), Glynis Luke a Lisa Banfield (PAVO).
L - R Freda Lacey (PAVO), Gill Colerick (Hafal), Glynis Luke & Lisa Banfield (PAVO).
Prif nod yr Eisteddfod yw hybu’r Gymraeg a diwylliant Cymru. Y diwrnod roedden ni yn yr Eisteddfod, roeddem yn ffodus i gael cymorth Lisa Banfield - mae hi’n gweithio yn yr Adran Gyllid, ac mae hi wrthi’n dysgu Cymraeg. Wrth gyrraedd y safle lle cynhelir yr Eisteddfod byddwch yn mynd i’r Maes - ac yma y ceir gwledd o bebyll amrywiol a stondinau sy’n llawn gweithgareddau, gan gynnwys y Pafiliwn Pinc hynod enwog. Edrychwch ar rai o’r lluniau gwych o’r Eisteddfod ar wefan yr Ŵyl, fydd yn rhoi blas i chi o’r hyn sy’n digwydd yno.

The Eisteddfod’s main aim is to promote the Welsh language and Welsh culture. Luckily our English-speaking team had the support of Lisa Banfield on the day we attended – she works in our Finance Department and is a keen Welsh learner. When you arrive at the valley where the Eisteddfod is hosted you find the Maes – which means “field” in Welsh and is where visitors are drawn to explore numerous marquees and stalls packed with activities, including the Eisteddfod’s iconic pink pavilion. Do check out some brilliant photographs on the Eisteddfod’s own website which give more than a flavour of the festival.

Penderfynodd PAVO gael themâu ar gyfer dyddiau gwahanol yr Eisteddfod ac estynnwyd croeso i grwpiau gwirfoddol eraill ar draws y sir i ymuno â ni er mwyn hyrwyddo eu gweithgareddau i gynulleidfa ehangach. 5 Awst oedd y Diwrnod Iechyd a Llesiant a chawsom gwmni Cymdeithas Ponthafren, Hafal, Ymddiriedolaeth Bracken a’r Gronfa Loteri Fawr.

At PAVO we decided to theme our days at the Eisteddfod and we invited other voluntary groups from around the county to join us and promote their activities to a wider audience. 5 August was our Health & Wellbeing Day, and we welcomed Ponthafren Association, Hafal, The Bracken Trust and the Big Lottery Fund Wales.

Jan Rogers, (Ymddiriedolwr – Cymdeithas Ponthafren), Rhian Davies (Prosiect YAPS, Cymdeithas Ponthafren)
Jan Rogers, (Trustee - Ponthafren Association), Rhian Davies (YAPS project, Ponthafren Association)
Roedd cyfle i ymwelwyr ymuno ag un o ymddiriedolwyr Cymdeithas Ponthafren, Jan Rogers, a chynrychiolydd y grŵp cysylltiadau cyhoeddus, Ken Davies, i greu clychau gwynt o gyllyll, ffyrc, llwyau, gemwaith a broc wedi’u hailgylchu. Yn ogystal, roeddynt yn dosbarthu gwybodaeth am y gwasanaethau amrywiol a gwerthfawr a gynigir gan yr elusen hon sy’n gweithio ym maes iechyd meddwl yng ngogledd Powys yng nghwmni Rhian Davies, sy’n gweithio ar y Prosiect Cymorth Cyfoedion Oedolion Ifanc ym Mhonthafren.

Visitors could join Ponthafren Association trustee Jan Rogers, and public relations group rep Ken Davies, to make wind chimes from recycled knives, forks, spoons, jewellery and driftwood. They and colleague Rhian Davies, who works for the Young Adult Peer Support Project at Ponthafren, also provided information about the varied and much valued services provided by this mental health charity in North Powys.

Daeth Gill Colerick, Swyddog Cefnogi Teuluoedd Powys gyda Hafal yr elusen iechyd meddwl i’r maes hefyd, ar ôl treulio Wythnos yn Sioe Frenhinol Cymru lle bu’n cefnogi’r Ymgyrch ‘ Gyda’n Gilydd Nawr!’. Mae’r ymgyrch yn teithio ar hyd a lled Cymru yn ystod yr Haf eleni, i fynd i’r afael â gwarthnod a phroblemau iechyd meddwl trwy gerddoriaeth.

Gill Colerick, Powys Family Support Officer with the mental health charity Hafal, was straight from her week at the Royal Welsh show where she joined the All Together Now! Campaign. This is travelling the length and breadth of Wales this summer, tackling stigma and mental health issues through the power of music. 

Ac ar stondin Ymddiriedolaeth Bracken roedd y nyrs Helen Davies yn rhoi profion pwysedd gwaed am ddim - profiad gwerth chweil yn yr Eisteddfod oedd mor hamddenol ei natur. Mae Ymddiriedolaeth Bracken, a leolir yn Llandrindod, yn cefnogi pobl yng Nghanolbarth Cymru i “fyw gyda, trwy a thu hwnt i ganser trwy ddod â chymorth proffesiynol a chymunedau cymorth at ei gilydd a thrwy greu canolfan eithriadol i gynnig gofal canser.”

And at The Bracken Trust stand nurse Helen Davies was providing free blood pressure tests – well worth doing in the relaxing atmosphere of the Eisteddfod. The Bracken Trust, based in Llandrindod Wells, supports people in Mid Wales “to live with, through and beyond cancer by bringing together professional help, communities of support and creating an exceptional centre for cancer care.” 

Daeth aelodau tîm Cyfathrebu’r Gronfa Loteri Fawr atom am y diwrnod hefyd. Ar hyn o bryd, maen nhw’n datblygu rhaglen cyllid newydd ar gyfer cefn gwlad, ac roeddynt yn awyddus i glywed barn y bobl.

The Big Lottery Fund Wales’s Communication team also joined us for the day. They are currently developing a new rural funding programme and were keen to hear people’s views.
Rosie Dent, Swyddog Cysylltiadau’r Gronfa Loteri Fawr yn gosod ei rhuban cochRosie Dent, Communications Officer at Big Lottery Fund Wales, pins her red volunteering ribbon
Roedd nifer o ymwelwyr â stondin PAVO yn awyddus iawn i ddysgu mwy am gyfleoedd gwirfoddoli o fewn y sir. Ac ar ôl cael sgwrs, bydden ni’n gofyn iddyn nhw osod rhuban ar ein map o’r DG i ddangos eu statws gwirfoddoli presennol - coch: rwyf eisoes yn gwirfoddoli; gwyrdd: buaswn yn hoffi gwirfoddoli; a gwyn: hwyrach y byddaf eisiau gwirfoddoli yn y dyfodol. Erbyn canol yr wythnos roedd Powys yn goch i gyd - arwydd fach o lwyddiant go iawn - mae pobl yn gwirfoddoli ar hyd a lled y sir yn barod!

Visitors to the PAVO stand were particularly interested to find out more about volunteering opportunities in Powys. And once we’d had a chat we asked some of them to pin a ribbon on our map of the UK to flag up their current volunteering status – red: I am already volunteering, green: I would like to volunteer, and white: I may wish to in the future. By the middle of the week Powys was already ablaze with red ribbons - a small symbol of a genuine success story – people really are volunteering like mad!

Ken Davies, un o wirfoddolwyr Grŵp CC Cymdeithas Ponthafren, gyda Choeden Ceiniogau Powys
Ken Davies, volunteer with PR Group at Ponthafren Association, with the Powys Pennies Tree
Buon ni hefyd yn hyrwyddo cynllun Ceiniogau Powys sy’n codi arian ar gyfer grwpiau cymunedol ac elusennau ar draws Powys trwy grynhau cyflog net staff i’r bunt agosaf, a’r ceiniogau dros ben yn mynd i’r cynllun. Ar hyn o bryd mae Cynllun Ceiniogau Powys ar agor i staff sy’n gweithio i PAVO a Chyngor Sir Powys, ond mae’n bosib y caiff ei ehangu yn y dyfodol. Caiff y cyfraniadau a gesglir eu dosbarthu i gymunedau ym Mhowys trwy grantiau cymunedol. Yn ystod yr Eisteddfod cafodd ymwelwyr gyfle i “Gyfrannu at gynllun Ceiniogau Powys” trwy ddewis eu hoff ganwr opera - Catherine Jenkins neu Bryn Terfel - ar goeden Ceiniogau Powys!

We also promoted the Powys Pennies scheme which raises funds for community groups and charities in Powys by rounding down staff net pay to the nearest pound with the spare pennies being donated to the scheme. Powys Pennies is currently open to staff working for PAVO and Powys County Council but may well be extended in the future. Contributions raised from the scheme will be distributed to communities in Powys in the form of community grants. At the Eisteddfod visitors had the opportunity to “Grow the Powys Pennies scheme” by choosing their favourite opera singer – Catherine Jenkins or Bryn Terfel – on the Powys Pennies tree!

Jackie Newey (PAVO), Menna Reese (Bwrdd Iechyd addysgu Powys)
Jackie Newey (PAVO), Menna Reese (Powys teaching Health Board)
Yn ystod y dydd, cefais sgwrs gyda Menna Reese sydd wedi gweithio ar brosiectau amrywiol gyda thîm iechyd meddwl Bwrdd Iechyd addysgu Powys Yn ddiweddar mae hi wedi bod yn rhan o ddatblygu prosiect cyfrifiadurol Mastermind, ym maes Therapi Ymddygiad Gwybyddol, ’yn ystod yr haf y llynedd bu Menna a’i chydweithwyr yn ysgrifennu am y prosiect hwn. Dywedodd Menna fod dros 100 o bobl ym Mhowys wedi cofrestru bellach ar-lein ar gyfer Therapi Beating the Blues Mae wedi addo diweddariad manwl ar gyfer y blog yma - felly gwyliwch allan amdano!

During the day I caught up with Menna Reese who has worked with Powys teaching Health Board’s mental health team on various projects. Of late she has been much involved in the development of the Mastermind computerised Cognitive Behavioural Therapy project, which she and her colleagues originally wrote about last summer. Menna told me that over 100 people in Powys had now signed up to the online Beating the Blues therapy. She has promised a more detailed update for this blog – so watch this space!

Lesley Griffiths (canol) y Gweinidog dros Gymunedau a Threchu Tlodi yn lansio Polisi Gwirfoddoli Llywodraeth Cymru
Lesley Griffiths (centre) Minister for Communities & Tackling Poverty, launched the Welsh Government Volunteer Policy
Lansiwyd nifer o brosiectau a chynlluniau pwysig ar stondin PAVO-WCVA yn ystod yr wythnos hefyd. Yn ystod y dydd buom yn gwylio dwy araith bwysig gan Weinidogion Llywodraeth Cymru.

Our PAVO-WCVA stand was also the venue for several important project launches and initiatives over the course of the week. During our day we watched two key speeches from Welsh Government Ministers and their chosen guest speakers. Most of the speeches were made in Welsh, but translation facilities were available for anyone who required them.

Lesley Griffiths, Gweinidog Llywodraeth Cymru dros Gymunedau a Threchu Tlodi, oedd yn lansio Polisi Gwirfoddoli newydd LlC, gyda’r is-bennawd: “Rydym yn cydnabod cyfraniad enfawr y Trydydd Sector i fywyd yng Nghymru”. Bu Elan, gwirfoddolwr ifanc, yn trafod ei phrofiad fel hyfforddwr chwaraeon gyda’r Urdd, ac wedyn bu Carwyn yn trafod ei rôl fel gwirfoddolwr gyda Pride Gogledd Cymru.

Lesley Griffiths, Welsh Government Minister for Communities & Tackling Poverty, launched the new Welsh Government Volunteer Policy, with the strapline: “We recognise the huge contribution made by the Third Sector to life in Wales”. Young volunteer Elan talked about her experience as an Urdd sports coach, whilst Carwyn from North Wales Pride spoke about his volunteering role.

Mark Drakeford, Gweinidog Llywodraeth Cymru dros Iechyd a Gwasanaethau Cymdeithasol fu’n rhoi anerchiad blynyddol ar Blant yng Nghymru
Mark Drakeford, Welsh Government Minister for Health & Social Services, made the annual Children in Wales speech
Yn ddiweddarach y prynhawn, rhoddodd Mark Drakeford, Gweinidog Llywodraeth Cymru dros Iechyd a Gwasanaethau Cymdeithasol, ddarlith flynyddol ar destun Plant yng Nghymru a’i ddewis destun oedd plant mewn gofal, ac wedyn, atebodd cwestiynau gan y gynulleidfa.

Later in the afternoon
Mark Drakeford, Welsh Government Minister for Health & Social Services, gave the annual Children in Wales lecture on his chosen topic of looked after children, followed by questions from the audience.

Glynis Luke (PAVO) gyda chyfaill o Sefydliad Prydeinig y Galon
Glynis Luke (PAVO) with friend from the British Heart Foundation

Roedd yn ddiwrnod prysur iawn, gyda llawer o ddigwyddiadau, ac fel y dywedodd pawb y buom yn sgwrsio gyda nhw, roedd awyrgylch yr Eisteddfod yn hynod gyfeillgar o ystyried maint yr ŵyl.

All in all it was a very full day, with lots happening, and, as everyone we met commented, one of the friendliest atmospheres we have come across at a large event or festival like this.

Wednesday, 5 August 2015

Freda Lacey on her new role in the Health and Social Care (H&SC) team, PAVO

Handing over the role - Senior Officer Health & Social Care
L - R: Trish Buchan (now on Powys Teaching Health Board), Freda Lacey (new in post)
One of my Health and Social Care team colleagues recently said to me that I should introduce myself to the Sector and tell people who I am. Because I’ve worked for PAVO in the Mental Health team for several years, I’ve assumed people know who I am. However, I recently met and had a very good conversation with the manager of the Brecon Volunteer Bureau who hadn’t heard of me before, so, I thought it probably was time to make myself more widely known.

The role

I have been recruited to fill the vacancy of Senior Officer Health & Social Care, as left by Trish Buchan who is now the Third Sector Organisation rep on the Powys teaching Health Board. At the time I started the nature of the role needed to shift to respond to current changes within procurement and commissioning, both in terms of the national context with new European Union guidelines, and locally, as more joint commissioning initiatives between the Health Board and Local Authority are developed.

I’m in the 7th week of being “inducted” into my new role and, in many ways, I feel familiar and comfortable with the direction of travel. I’ve been reflecting on the changes I’m witnessing and while the nature of the work is somewhat different to what I had been doing within my previous role in Mental Health, this new work also relies on a foundation of forming good relationships and engendering open, timely communication between the Sector and our colleagues within the Health Board and Local Authority.

My role can be broken down into several key activities:

  • To help broker possibilities for collaboration within the commissioning process.
  • To act as a conduit for timely information and response.
  • To offer general and focused support to organisations and networks responding to business development opportunities.
  • To represent the third sector on strategic management boards with Health Board and Local Authority colleagues.
Ultimately I am there to help ensure that voluntary organisations involved in Health and Social Care are engaged and equipped with what they need to respond quickly to changing needs within public services.

This is me 

So who am I personally? I’m drawn to use a process/initiative which forms part of caring for people who have been diagnosed with a dementia to help me tell you who I am. Publicised by Alzheimer’s Society, their “This is me” activity provides the tools for telling the key parts of someone’s life story. I’ve found the process very fruitful as an exercise in self-reflection and hope that it gives you a flavour of who I am - you can read it here. 

L - R: Freda Lacey, Claire Powell, Anne Clark, Ruth Middleton - Health & Social Care team

Who are we as a team and what are we about?

Pete Lathbury is the Head of Third Sector Support and as such helps give our team direction.

There are four of us (two part-time and two full time) in the Health and Social Care team. Myself, two third Sector Brokers – Anne Clark and Claire Powell, and Ruth Middleton who helps collate and provide vital information to the Sector on Health and Social Care news and manages our network events.

In reflecting on my first seven weeks’ highlights:

  • I have helped plan and deliver a recent Health and Social Care Network event.
  • Attended a Virtual Ward meeting in the North in addition to engaging with the Third Sector Brokers as they attend others that are being developed or rolling out rapidly.
  • Helped facilitate two Sector meetings with colleagues providing Carers’ Services that are being recommissioned by the Council.
  • Initiated 10 meetings with Sector, Local Authority and Health Board key influencers.
  • Met with the Local Authority commissioner and Disability Powys relating to the Physical Disability and Sensory Loss (PDSL) commissioning engagement strategy.
  • Met and discussed service level agreements with three Health and Social Care third sector organisations delivering services for older people.
  • Attended a scoping workshop with the Health Board looking at their Strategy for Consultation and Engagement.

Freda updates attendees at the recent Health & Social Care Network event

To say my first seven weeks have been eventful would be an understatement and yet, I am finding the work very varied, interesting and exciting. I am also endeavouring to be mindful of my capacity, that of the team and balancing priorities.

The process of change, in having to respond to the Council and Health Board’s challenges about reducing costs, the needs of the citizens of Powys, and the current landscape of shifting more public services into and onto the community, are all driving the strategic public agenda forward at a rapid rate of acceleration.

While there are always opportunities in transforming services, there are also threats to the ways things have currently been and expected to be (sometimes for years) and the levels of discomfort and fear that rapid change engenders cannot be under estimated.

One of the important parts of my role, and the team’s going forward, is to ensure that we provide timely communication about what is happening, provide a forum for sharing information, and ensure that the Sector can jointly collaborate within local, strategic service planning and delivery.

I am very much looking forward to getting to know Health and Social Care colleagues in more depth and gaining greater understanding of the pressures being faced. I welcome open contact, communication and feedback.

So do get in touch by emailing freda.lacey@pavo.org.uk or calling 01597 822191.

Wednesday, 29 July 2015

Advance Statements for Crisis Planning

by Janet Rogers and Derek Turner


Possibly for the first time in history, the new Mental Health Act Code of Practice (April 2015), for England, has included a section that puts a responsibility on Mental Health Practitioners to encourage
‘patients’ to set out their wishes in advance as ‘statements’ or ‘decisions’. While advance statements are not legally binding professionals are advised that they ‘should make all practical efforts to comply with these preferences and explain to patients why their preferences have not been met.’

Within the Code Advance Decisions relate to medical treatments and should be adhered to by practitioners whenever possible, whereas Advance Statements can be used to cover a wide range of factors that might affect the life of a person who experiences difficulties as a result of their mental health, and how other people, as a result, become involved in the person’s life. This article aims to explore the rational for writing an Advance Statement to assist Practitioners in supporting a person who might experience a mental health crisis at some point in the future. The history of psychiatry has been dominated by Practitioners who have tried to design interventions that can be used to control/manage/support/treat a person whose behaviour is deemed to be ‘insane’. It may seem to some pointless, or at best counter-intuitive, to ask someone who is ‘insane’ to plan their own crises, however with some 30 years or so of learning to listen to, and learning from, people planning their own mental health recovery journey, a realisation is slowly beginning to dawn that this is the only sane way forward. The early pioneers of recovery have not only engineered fulfilling lives for themselves but have given new insights that are now at the forefront of what is considered to be ‘best practice’.

The key to ‘recovery based practice’ for Practitioners is developing a capacity to think differently about ‘how’ to use hard earned skills and expertise. Perversely it has been the drive towards ‘evidence based practice’ that has embedded a culture that suggests that ‘what’ Practitioners do is important. Interestingly it has been the Police who, in becoming increasing dissatisfied with ‘what’ they have been doing, have become open to different ways of working that are more concerned with ‘how’ they engage with the person.

More often than not it is the Police who are the front line service when a person is in crisis. The Mental Health Act gives the Police powers to ‘arrest’ the person and ‘remove’ them to a ‘place of safety’ where they can be assessed by other Practitioners. In the past this has often meant that the person has been bundled into a Police van and transported to a Police Cell. The Triage Pilot, currently being run by Dyfed-Powys Police, has already shown that the numbers of people traumatised by such an experience can be dramatically reduced by engaging with the person and their particular circumstances. The Pilot includes a follow-up visit to each person and it is here that the potential for encouraging people to write and agree their Advance Statements could potentially reduce trauma even further.

Advance Statements can be very simple agreements or more complex arrangements. An example of a very simple statement was told to me recently by a lady who has been prone to panic attacks when out shopping. These are very distressing to her and worry people who are near her. Recently a member of the public called the Police and a female Community Constable arrived. The Constable was not fazed by the situation and encouraged the lady to go with her to a local café. With a cup of tea and a bit of a chat the panic subsided. The lady was then able to tell the Constable that if she had been ‘arrested’ and taken to a Police cell she might not have been able to go out shopping again for many months as she would be fearful that this might happen again. They agreed together that a note would be put on her file saying that going to a café and having a cup of tea and a chat was the best way to deal with a situation like this if it happened again in the future. In telling this story the lady was able to say that she now felt more confident going out shopping knowing that, if she had a panic attack and the Police were called, she would be treated in the same way by any Police Constable.



Another situation involved a woman who had had many ‘arrests’ by the Police, some were very traumatic and others were less so. In talking things over with an advocate this woman was very clear why some Police Officers found her very difficult to manage while others treated her as a member of the community who needed some support to get through the current crisis. In trying to manage her distress she needed to move around and she would be aware that her fists were clenched. Police Officers who did not know her often interpreted this behaviour as aggressive while those who knew her allowed her space to work things through. Police Officers were often at a loss to know what to do with her as her thoughts made no sense to them at all. As a consequence she frequently found herself bundled into a van and transported for anything up to 2 hours in order to be assessed by other mental health Practitioners. The woman understood why the Police behaved this way but she was keen to write an Advance Statement that, if agreed, might mean that she could manage the crisis with the help and support of the Police and other important people. She knew that the person who would have the most calming effect on her behaviour was her husband. He was prepared and willing to be contacted by the Police and to come at short notice. She had this agreement with her husband already and so she needed the Police to agree to make the phone call when required. She also recognised that she sometimes needed a ‘place of safety’ but travelling long distances was very difficult for her and her family. She needed a separate agreement with her local Community Mental Health Team if she was to be able to use one of their rooms to fulfil this purpose.

It can be seen from this example how a range of other factors might need to be considered. Each of these may require separate agreements with the people involved if the Advanced Statement is to have the desired outcome.

Even with the full support of the Code of Practice the introduction of Advance Statements is likely to be slow. There are several reasons for this:

  • Trust is probably the biggest factor for most people. Survival in the mental health system has, for many people, been closely linked to keeping Practitioners in the dark about the reality of their mental health systems.
  • There is a more general scepticism in society about voluntarily sharing personal information with the Police.
  • Another survival strategy that many people use is denial: “It won’t happen again.”
  • There are currently no support systems in place to help people to make an Advanced Statement.
Developing a culture where people retain control and responsibility for their mental health, even at times of crisis, will take time, experience and evidence. Investment is needed, whether this is investment of time to encourage people who have had a good experience to embed this in future practice, or financial investment in advocacy services, there is now an opportunity, with the backing of the Code of Practice, to build a future where trust is rewarded, where the Police can work cooperatively, where crisis becomes the trigger for ‘recovery’, and where support is common practice.

Janet Rogers is a trustee at the mental health charity Ponthafren Association, and has previously written for this blog on Volunteering whilst getting benefits and Mental Health 1983: Code of Practice - the review (in England). 

Derek Turner worked for the PAVO mental health team for many years. He is now retired, and runs The Thomas Shop in Penybont with his wife Liz.

Thursday, 23 July 2015

Hafal's All Together Now! Campaign Rocks at the Royal Welsh!

 Aims to unite people through music

Glynis Luke (PAVO mental health team - far right) being photographed
with an army dragon mascot and Hafal staff
High summer is here - time for shows and festivals and having fun. My colleague Glynis Luke was at the Royal Welsh Show earlier this week, and met up with staff and visitors at the stand of the mental health charity Hafal where she was introduced to a giant blue dragon and listened to some banjo playing amongst other things...
A visitor to Hafal's stand plays the banjo!  Photo courtesy Hafal
"We get by with a little help from our friends"
The Beatles

I visited the Hafal stand at the Royal Welsh Agricultural Show earlier this week to find out more about their All Together Now! Roadshow. The campaign is promoting opportunities for peer support and wider social integration for both clients and carers with a priority to develop the social life sections of individual care and treatment plans and sharing information of appropriate agency referral. Run by service users and carers, and supported by Hafal, Bipolar UK, the Mental Health Foundation and Diverse Cymru, the All Together Now! Roadshow is currently travelling across Wales and calling at music festivals and events taking place in each of the 22 counties. 

The Hafal staff were all wearing annotated All Together Now! purple T-shirts (the colour of recovery). There was a huge welcome at their Royal Welsh stand, including a cup of tea, and the sun was shining (I was ignoring the slight drizzle of rain). 

Gill Colerick, Hafal's Powys Family Support Officer  Photo courtesy Hafal
I met up with Gill Colerick, a former colleague from PAVO. She introduced me to her colleagues and told me more about the campaign and her work in Powys. Gill is Hafal's Powys worker, setting up groups for carers of those with "serious mental illness" in the county. Gill and I chatted about the benefits of both music and animals as good therapy when connecting with people experiencing mental distress.

I haven't played any musical instruments since the recorder at school, but I love to hear music and will dance around the house to my favourite songs. I will sing away in the car too when I don't think anyone can hear me! It's universal - it touches everyone's heart. It can bring all sorts of different emotions to the surface. I grew up in a musical family, my Nan used to play the piano. I have an image of people gathering round the piano as she played, and we would sing. My father used to sing for Brighton & Hove Opera, he used to be in all the musical shows and knew all the words to the songs.

"I like to boogie!"
T-Rex

I was able to speak to other visitors to the stand, including the wife and carer of a gentleman with dementia. She shared with me a variety of the difficulties that had been encountered since his eventual diagnosis of dementia, as well as the impact on family and friends. She said, “It’s difficult to know where to go to get help, what is ‘out there’ and when it's available, we ‘alternate’ between good days and not so good days…… Weekends are the hardest, it can be quite lonely.” I was able to share details of the Welsh Dementia Helpline with her. 

Visitors to the Hafal stand    Photo courtesy Hafal

Getting out and meeting people at events like the Royal Welsh Show can reduce isolation and that feeling of loneliness. There are practical, achievable things you can do now which could reduce your chance of developing dementia or, at the very least, improve your general health and wellbeing, and I was able to share some of these with her. Research has identified many risk factors associated with dementia, you can find out more at The Alzheimer’s Society website.

The famous Hafal VW camper!
I popped inside the VW camper to take a look. There were boxes of toys for children playing in there. You could measure your height against the blow up green snake and try out a pedometer. If members of staff were around children were allowed to sit in the front! It was a great way to keep youngsters busy while people were talking to the Hafal staff.

"If we hold on together"
Diana Ross

L-R: Dawn Williams (Hafal), army dragon mascot, Gill Colerick (Hafal),
Glynis Luke (Mental Health team - PAVO)   Photo courtesy Hafal

All Together Now!, was officially launched at the Norwegian Church Arts Centre in Cardiff Bay by Health and Social Services Minister Mark Drakeford AM. 

Launching the event the Minister said: “Music has an ability to connect to the emotional side of our lives in ways that very few other things do. And we know this very well in the field of mental health.

“This campaign, as it goes around Wales, will use the All Together Now! strap line to draw people into a much wider set of discussions about their own place in the world and about connecting to people who have shared their own experience, but do it in a way that has a lot of joy!”

"Take a chance on me"
Abba

Monday, 13 July 2015

Health & Social Care Network events - a mental health perspective

PAVO teams in Health & Mental Health
L - R: Ruth Middleton (Health, Social Care team), Anne Woods (Mental Health team),
Pete Lathbury (Head of Third Sector Support), Freda Lacey (Senior Officer HSC),
Jackie Newey (MH), Claire Powell (Third Sector Broker & Info-Engine Officer)
Have you come across the PAVO Health & Social Care Network events? I was asked to help out at the latest one (well, it does say Health in our team title) along with colleagues from Mental Health and Health & Social Care. The event took place at the Subud Centre in Brecon last week on 8 July. Anyway, whilst I was more than happy to help shift tables, take photographs and scribe for part of the day, it also seemed like the ideal opportunity to find out more and share any updates to the wider world - so, here we go! I hope you find it useful.


Three of the key benefits available to members of the Health & Social Care Network, (which is open to any voluntary sector organisation providing support to individuals and those close to them) are:
  • Opportunities to contribute your views and those of the people you support on current and future health & social care services.
  • Networking opportunities with other third sector organisations and key partners.
  • A catalyst for cross agency collaboration to meet changing health and social care needs.

Top table, L - R: Pete Lathbury, Gloria Powell (PAVO Trustee & HSCN Chair),
Freda Lacey, Jayne Bevan (Strategic Programme Manager, Powys County Council).
This particular event provided an opportunity to question Commissioners on procurement and commissioning strategies for Powys, to hear updates from the Welsh Government about new procurement regulations and how that would impact locally, to find out more how Primary Care services are interacting with the voluntary sector, and the key aims and objectives of Powys teaching Health Board, specifically in relation to working with the sector.

First up was Jayne Bevan, Strategic Programme Manager at Powys County Council. Jayne led on the consultation around proposed changes to the Eligibility Criteria for Adult Social Care in Powys which took place earlier this year. Welsh Government's aim was to ensure an equitable service across the country, and on 1 April this year PCC decided to change its eligibility criteria which means that access to some social care support services will only be available to those with critical and substantial needs (previously it was available to those with moderate needs). Those with low or moderate needs will be signposted to universal services, such as services to prevent social isolation. This change comes into effect on 1 April 2016, but prior to that there will be engagement with people in contact with services and local organisations in Autumn 2015. Find out more in Jayne's presentation here.

Jayne was followed by Pete Lathbury, Head of Third Sector Support at PAVO, who spoke about the recent survey on the Third Sector's capability in Powys in relation to health and social care. The survey looked at three service areas: formal advocacy, specialist information and supported independent living. Questions drilled down to explore who provides mainstream services, to look at the health and resilience of the services both now and in the future, and to explore the support needs of organisations looking to provide a strong and healthy service. Pete's presentation is here.

L - R: Trish Buchan, (Independent Member Powys teaching Health Board)
and Freda Lacey, her successor at PAVO as the new Senior Officer Health & Social Care.
Trish Buchan, Independent Member Powys teaching Health Board, recently left her role as Health & Social Care lead at PAVO to focus on her position with the Health Board, and at this event she introduced everyone to the PtHB Strategic Plan. With the help of some new acronyms (Integrated Medium Term Plan - IMTP), and a Vision - "truly integrated care based on the needs of the individual", we then found out more about the key aims and themes of the strategy. Two headlines - 'care closer to home' and 'an increased use of technology' were particularly relevant to mental health. We have already written about the computerised Cognitive Behavioural Therapy scheme called Mastermind, currently being rolled out in Powys.

Trish emphasized the need for increased effective partnership working, with a specific mention of mental health again here. You can read Trish's presentation here.

Pete followed with the Third Sector perspective on the new health board strategy (read here). With the move to more localised services, there was a sense that there could potentially be more activity for voluntary sector intervention. Pete then discussed in more detail specific issues relating to this, including volunteering, community capacity, co-ordination and integration and commissioning. If I remember one fact from this presentation it is that there are over 26,000 volunteers in Powys - the physical and emotional wellbeing impact from that is clearly huge.


Alan Lawrie (pictured above left), Director of Primary Community Care (South) followed with an update on Primary Health Care & Third Sector Engagement. Alan has worked in health services for 33 years now, and said that the situation in Powys "is generally pretty good" compared to other parts of the UK. However, there are vulnerable areas, especially around recruitment, and he supported adoption of new workforce models, so for example, pharmacists would be able to prescrible independently, and advanced paramedics taken on in certain situations. Alan was clear about what the NHS wanted from the voluntary sector, solutions around: social isolation, admissions prevention, discharge support, transport, chronic disease support and links to social enterprise. No pressure there then! Read Alan's presentation here.


Nicola Maliphant (above) is a Senior Project Manager, Policy, at Value Wales, Welsh Government. She was at the event to give us an overview of Public Procurement Policy in Wales, and specifically further details of the new European Commission regulations which came into effect on 26 February 2015. This is particularly relevant for those organisations which will be taking part in a tendering process with either Powys teaching Health Board or Powys County Council over the coming months. Nicola was keen to impress upon her audience that Value Wales is there to provide support, in particular sessions on joint bidding and consortia are recommended. Read more here.


So we'd heard the national policy around procurement, and it was time for a more local view of things. This was supplied by Shelley Davies - pictured above (speaking on behalf of Dominique Jones, Health & Social Care Implementation Manager), who gave an update on Powys County Council's Commissioning Strategy. Shelley explained that good practice in the Children & Young People's team (her speciality) was being brought across to adult services. It was particularly interesting to hear about the aim to develop more social enterprises in the sector, though Shelley had some valid questions around - who would facilitate these social enterprises and who are the people to kick start activity? 

Alan Lawrie then summarised Powys teaching Health Board's Procurement Strategy (slides 12 - 14). Alan again talked about applying the children's model around procurement to an Older People's Perspective.

Powys teaching Health Board's Integrated Services Wellbeing Wheel

Throughout the day Freda scheduled a number of question and answer sessions with the speakers which gave everyone the opportunity to get involved. There are also some additional documents available on this PAVO webpage.

So, is this kind of information of interest to your organisation? Please let us know by commenting below, or join other mental health organisations such as Hafal, Ponthafren Association, Mid Powys Mind and Brecon & District Mind, who all attended this HSCN event to find out more about current issues relevant to them.

Thursday, 2 July 2015

Five top sportsmen and women talk about mental health

It’s one of my favourite times of the year – Wimbledon fortnight! Sport plays such a big part in so many people’s lives, whether as participants or spectators or both. For me – well, playing tennis is definitely not one of my strengths – but I just love to watch or listen on the radio. You can’t help but admire the abilities of top sportsmen and women at the peak of their game.

But there is another side to sport, and particularly over the last few years we have become more aware of the impact that the pressures of playing at the top of your game can potentially have on your mental health. Organisations such as Mind have written on the subject. And it is summed up well by Liz Lockhart on Mentally Healthy:

"We see pictures of athletes enjoying a celebrity life-style, out on the town, mixing with the ‘beautiful people’ but we rarely stop to consider the downside to the pressure that comes with success. Players must feel dreadful ‘lows’ when they are not selected and a huge emptiness when they face retirement.

The message, which must reach the ears of sportsmen and women at all levels in their game, must surely be that they need to recognise when they are having difficulties. To seek help without fear if they feel the need for it, and to realise that their mental health is as paramount as their physical health. You can’t have one without the other."


Here in Powys we have found that when people tell their stories it can be enormously helpful, both to those doing the telling and those listening or reading. So here are links to the stories of five top sportsmen and women who have talked openly about being touched by issues relating to their mental health. Their coping strategies can help all of us looking to improve our own mental health.

Frank Bruno – boxer

Frank is a former British professional boxer who competed for over thirteen years. He won 40 out of 45 bouts, including the World Boxing Council world heavyweight championship in 1995. He retired in 1996 after receiving a serious eye injury during a fight with Mike Tyson.

Rachel Bruno, Frank’s daughter, was 16 years old when her father was first sectioned, aged 41, in 2003. She and her father talk openly and honestly about the impact his mental distress has had on the family on the Time to Change website.

Frank also spoke in 2013 about how returning to boxing training was helping his mental health.

"If you can do some form of exercise, it clears your head, sets you up and paves the way for you….Try and go to yoga, try and do a bit of walking, a little bit of jogging, go to an aerobics club, go to a gym, go to a sauna or swim. Just think healthy and try and do healthy things. Sometimes it clears your head.”

Clarke Carlisle – footballer

Clarke played for a number of top clubs during his 16 year playing career including Queens Park Rangers and Burnley before retiring in 2013. He was also chairman of the Professional Footballers’ Association. In 2013 he presented the BBC’s Football’s Suicide Secret programme. 


"I still bear the scars from my battle with mental health. I kept my depression a secret from clubs and teammates for almost two decades and it almost cost me my life….. (Now) I want to do all I can to raise awareness of the importance of mental health - not only to break down the stigma and taboos but also to make sure people know where they can find support."


Clarke now talks about his experiences at conferences and events. In October he will speak about mental well being in the workplace, at a conference in Jersey organised in conjunction with MIND Jersey.

Clara Hughes – cyclist and speed skater

Clara has won medals at both the Winter and Summer Olympics for her home country of Canada. Then her life took a different turn when she began to feel depressed.

“I felt ashamed of how I looked and how I was. It was easier not be around people. I was really afraid and alone.”

She now fronts a national campaign called Let’s Talk, set up to spark a conversation about the realities of mental health and ending the stigma – covering issues just as relevant in the UK as in Canada. She describes how poor mental health impacted on her sport and what happened next in a TV interview.

“More than anything I have ever done in the Olympics this has affected people.”

Sir John Kirwan – rugby player

John played rugby union and rugby league for New Zealand for many years and is now a Rugby Union coach. But he received his knighthood in 2012 for services to mental health as well as rugby.

“One day I was happy go lucky JK … (then) the biggest fear for me was that I was never going to be well again…. " Now he says: "Hang on to hope, grab hold of it.”

Originally he saw seeking help as a weakness, and that he would be regarded as a failure. But then he reached out – he now recognises that depression is not a weakness, it is just something that happens.

John fronted a series of TV interviews in his native New Zealand to combat the stigma associated with depression.

John’s story also features on Whirlwind Stories, a website set up to help enable men to positively embrace their mental health through the sharing of stories.

You can watch a longer interview with John Kirwan at his home in Italy where he shares his strategies for living with depression.



Rebecca Marino – tennis player

Rebecca Marino played tennis professionally for Canada and took on the likes of Venus Williams at the 2010 US Open. A year later, in 2011, she was on the courts at Wimbledon. But she was due at another tournament in the UK when she first spoke to her coach about her depression.

“I was just sad and I couldn’t contain it.”

At first she found it hard to talk to her family and friends about her distress. But when she did, she realised: “Opening up to them was the best thing I’ve ever done.”

Rebecca was at the top of her game, number 38 in the world, and yet the saddest she had ever been. At the age of 22 she decided to retire from professional tennis and go to university instead. You can watch her TED talk about her experiences "Slipping Through the Cracks: Pro Athletes and Mental Health".

Rebecca wants to highlight that it’s OK to feel weak or sad and share your feelings. She feels people are slipping through the cracks, even though there are organisations to help people, she feels individuals are scared or do not know where to go for help. This is why she told her story.

Has sport played a role in your mental health journey? Let us know in the comments box below, or email: pamhinfo@pavo.org.uk